New Delhi: In what should set alarm bells ringing for India which proposes to end Tuberculosis (TB) by 2020, a new study has projected startling increase in drug resistant TB in India in next two decades, if current TB management remains unchanged.
According to the study published in the Lancet, cases of drug resistant TB are fore-casted to increase in four high burden countries including India, Philipines, Russia and South Africa so much so that by 2040, drug resistant TB will make up 32.5% of all TB cases in Russia, 12.4% of TB cases in India, 8.9% of TB cases in the Philippines, and 5.7% of TB cases in South Africa. This compares to almost a quarter of cases (24.8%) in Russia, 7.9% in India, 6% in the Philippines, and 2.5% in South Africa in 2000.
According to experts, between 2000-2040, a third of tuberculosis cases in Russia are predicted to be drug-resistant; compared with one in ten in India and the Philippines, and one in 20 in South Africa. In addition, almost one in ten cases of multi-drug-resistant tuberculosis in each of the four countries were expected to be extensively drug-resistant by 2040 (9% in Russia and the Philippines, 8.9% in India, and 8.5% in South Africa), compared with around 1% in 2000 (1.3% in Russia, 1.6% in the Philippines, 0.9% in India, and 0.4% in South Africa).
Latest figures estimate that every year there are 10.4 million new cases of TB, leading to 1.8 million deaths globally. Nearly 40% of all drug-resistant TB cases occur in Russia, India, the Philippines, and South Africa – accounting for more than 2,30,000 cases of drug-resistant disease in 2015.
The study authors propose that increased spread from person to person will be responsible for the growing number of drug-resistant tuberculosis cases. Significantly, the study predicts that fewer cases of drug-resistant tuberculosis will be caused by strains acquiring resistance – reducing from around 30% of cases of multidrug-resistant tuberculosis in 2000 to 20-25% in 2040, and 80% of cases of extensively drug-resistant disease in 2000, to 50% in 2040.
Talking to this newspaper, Paul Jensen, director of policy and strategy, International Union Against Tuberculosis and Lung Disease, said, “Resistant TB endangers the health and security of every country. Unless something changes, the day will soon come when we’re facing the international spread of an incurable airborne disease. The chance to stop that from happening is now. Drug-resistant TB is one of the most difficult illnesses that a person could ever experience. For every five people who contract drug-resistant TB, four go without access to treatment. This is a crisis”.
“While better access to treatment programmes will reduce rates of drug-resistant TB in countries with a high burden, they will not eradicate the problem alone, and current efforts may not be enough to reverse the epidemic,” said the Lancet.
